Movements between regions, the chaos of monitoring: delayed data and different criteria


A mountain of data, often provided with different criteria, sometimes two or three weeks late, without adequate statistical sampling. On this basis, the weekly monitoring provided by the Regions according to the decree of April 30, the Ministry of Health and the Higher Institute of Health work to evaluate the reopening of the “frontiers”between the Regions and the progressive, and still uncertain, return to normal.

The anomalous reports

In recent days, there have been many reports of anomalies in the reports of the Regions, which put the entire system at risk. As in a false syllogism, if the premises are wrong, the conclusions will be wrong. Mistakes resulting from simple inaccuracy, structural inability of the system or result of programmatic deviations? For Professor Nino Caltabellotta, president of the Gimbe Foundation who systematically analyzes the reports, “the fact that the Region is the owner of the monitoring exposes to opportunistic behavior”. Biologist Enrico Bucci says it in even clearer terms: “It is obvious that if you ask the Regions to provide you with decisive data on openings or closings, they will determine what and how to give them according to internal political logic”. Beyond any mystifications, there are errors that blatantly emerged in recent days. The Gimbe Foundation found that hospital discharges are reported in Lombard reports, with an overestimation of the healed. Always in Lombardy, according to Everyday occurrence, confirmed and symptomatic cases would disappear from the Milan infection chart from 11 May. Trentino suddenly went from an average infection / swab ratio of over 4% on April 28, with serious concerns, to the ultra reassuring ratio of May 11, of 0.14%. Not a miracle, but a calculation of lower contagions by mistake. In the Marche, only symptomatic cases began to count from one day to the next.

The number of swabs

From the Regions come excel sheets, when it is good, which say little or nothing for serious analysis. Undersecretary Pierpaolo Sileri calls for “more accuracy”. But it is a structural deficit. Because, for example, we know the total number of swabs, but we do not know facts to whom and how, if it is the first or second confirmation, if it is done symptomatic or not. This prevents prioritization of subsequent buffer policies. Tracking should also be based on antibody tests. Lombardy does not recommend fast ones, although several scientific studies have meanwhile established their reliability. It is not clear how many have been made and to whom. For alleged privacy reasons, the mortality data of the individual municipalities are not known. In the overall count, only deaths in hospitals end, confirming the “hospital-centric” perspective of Lombardy. Michele Usuelli, doctor and regional councilor in the running to become president of the Commission of inquiry, explains: «The communication strategy of the Lombardy Region must also enter Phase 2. I would like a public debate to decide, after hearing the opinion of the Health Commission and the Regional Council, what are the numbers that it is useful to provide now ».

The Rt

It would also be useful to understand what happens when the number of inpatients in intensive care decreases: are they deaths or extubated? It is not known. As for the famous Rt, the index that measures the reproduction of the virus after containment measures, is based on old data, with lockdown in force, and not parameterized: hence the case of Umbria which, due to an increase from 11 to only 24 infected, has undergone a surge in the alert, because the data is not proportionate to the total number of cases. In Lazio the local health authorities and hospital companies transmit data to Seresmi dello Spallanzani at different intervals, every 24 hours or every week. Another report bug: to correctly establish the RT, the Regions should provide the date of onset of the symptoms. On average, for the numbers to be reliable, at least 50 percent of the data would be needed. But in at least nine Regions that figure is not reached. And so it was decided to lower the trust threshold to 30%. For Caltabellotta «according to international standards, 200/250 tampons per day per 100 thousand inhabitants should be made. But very few regions have increased the diagnostic swabs, only Val d’Aosta and Trentino. If the curve worsens, only the cases of those who get worse in such a way as to have to go to the hospital will come to the surface. And this could happen suddenly with all the serious consequences we have already seen. ” Adds Bucci: «We would also need a sampling of the data: who were the swabs made of? And where?”. His conclusion is drastic: «We have no reliable data. And we use them with wrong parameters ».

May 23, 2020 (change May 23, 2020 | 07:12)


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